Asian American Research Articles

Cardiovascular risk factors and disease mortality among asian american subgroups

Abstract Background Asian Americans are the fastest growing racial group in the United States. Although Asian subgroups have distinct cardiovascular (CV) risk profiles, they are often aggregated together for public health surveillance. Purpose We provide the first comprehensive national estimates of CV and CV risk factor mortality in Asian American subgroups to assess differences in CV risk. Methods We used CDC WONDER, which captures all death certificates in the US (2018-2020), as well as the American Community Survey for demographic data. Adults aged ≥18 years were included. Estimates of age-adjusted overall CV mortality, as well as heart disease, hypertension, and stroke-related mortality, were determined by ICD-10 codes. To compare the contribution of each cause of mortality among subgroups with different baseline all-cause mortality rates, proportional mortality rates were determined by race. Proportional mortality was defined as the mortality rate of each condition divided by the all-cause mortality for that race group. Differences in proportional mortality by race and ethnicity, compared with White American adults, were assessed with age-sex adjusted linear regression. Results The US population consisted of 12,950,565 Asian Americans (53.7% female). Among the Asian American subgroups, 25.4% were Asian Indian, 28.5% Chinese, 19.7% Filipino, 5.3% Japanese, 9.6% Korean, and 11.8% Vietnamese. A total of 160,282,147 adults were White. Age-adjusted baseline mortality rates are shown in the Table. Compared with White adults, Asian Indian (34.5% vs 29.3%; adjusted difference 5.2%, [95% CI: 1.8%, 8.6%], P=0.009) and Filipino (32.8% vs 29.3%; adjusted difference 3.5%, [95% CI: 0.1%, 6.9%], P=0.04) adults had significantly higher proportional mortality from all CV causes. Asian Indian (26.0% vs 22.6%; adjusted difference 3.2%, [95% CI: 0.3%, 6.2%], P=0.04) adults had higher proportional mortality from heart disease than White adults, while Korean (17.3% vs 22.6%; adjusted difference -5.2%, [95% CI: -8.1%, -2.2%], P=0.01) and Vietnamese (17.5% vs 22.6%; adjusted difference -5.1%, [95% CI: -8.0%, -2.1%], P=0.01) adults had lower proportional mortality. Every Asian American subgroup had higher proportional mortality from hypertension causes compared with White adults, except for Asian Indians (Figure). In addition, every Asian American subpopulation had higher proportional mortality from stroke compared with White adults (Figure). Conclusions CV risk factor and disease-related mortality varies substantially among Asian American subgroups. Public health efforts targeted to address CV health disparities among the diverse group of Asian Americans are needed.

White Americans who perceive themselves to be “last place” in the racial status hierarchy are most drawn to alt-right extremism

Economic inequality and alt-right extremism have reached historic highs in the U.S. We propose that high economic inequality may uphold stereotypes that white people are wealthy which may lead some white Americans to feel in the precarious position of falling behind their racial group’s high status. For white Americans who also feel that they are being passed in status by People of Color, such perceptions may make ideologies that aim to benefit white people particularly appealing. Across two studies (Pilot: N = 465; Study 1: N = 1,449), using representative quota sampling of non-Hispanic, white Americans, we combine a measure of subjective status with latent profile analysis to identify white Americans who feel they are in “Last Place” (i.e., falling behind most white, Black, Asian, and Latinx Americans). Controlling for objective status, white Americans in this “Last Place” profile were most likely to support alt-right ideology, politicians, and events.

Survival Improvement of StageIV Non-small Cell Lung Cancer in the Immunotherapy Era: A Retrospective Cohort Study in a US Population.

Immune checkpoint inhibitors (ICIs) greatly improved outcomes of stageIV non-small cell lung cancer (NSCLC) in randomized clinical trials. Limited data exists regarding the survival improvement of ICI use at the population level. Clinical data of patients with pathologically confirmed stageIV NSCLC diagnosed in 2013 and 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Survival outcomes were compared before and after ICI use to assess the survival improvement in the immunotherapy era in the real world. A total of 19,433 patients with stageIV NSCLC were included. Being female, age < 60years, of American Indian and Asian or Pacific Islander race, married, non-squamous histology, without bone, brain, or liver metastases, and receiving chemotherapy were significantly associated with better prognosis in multivariable analyses. Propensity score matching (PSM) based on associated factors resulted in 8743 patients each in the non-immunotherapy and immunotherapy groups (1:1 ratio). After PSM, both overall survival (OS) (p < 0.001) and cancer-specific survival (CSS) (p < 0.001) were significantly improved in the immunotherapy group. The median OS (mOS) was 6.0months in the non-immunotherapy group and 8.0months in the immunotherapy group. The 1-, 2-, and 3-year OS rate was 29.0%, 14.2%, and 8.5% in the non-immunotherapy group, and 37.8%, 23.5%, and 16.7% in the immunotherapy group, respectively. Patients who were male, under 60years old, married, white, had adenocarcinoma, had no bone or liver metastases, and received chemotherapy or radiation therapy were more likely to benefit from immunotherapy. Survival outcomes of patients with stageIV NSCLC were significantly improved in the immunotherapy era. Population-level benefits of survival varied among subgroups, and not all the increase in OS meant a clinically meaningful benefit.

The relationship between familial factors and youth mental health outcomes in Korean American families: The mediation effects of youth's negative emotionality.

Depressive symptoms are one of the mental health problems among Korean American (KA) youth. Although several studies examined mental distress among KA youth, few have examined the associations between different familial factors, negative emotionality, and depressive symptoms among them, especially using longitudinal data. Drawing on the Triadic Model of Family Process (TMFP), this study examined the longitudinal associations between Korean-specific aspects of familial factors and depressive symptoms among KA youth and the mediation role of negative emotionality in the relationships. Using KA youth and parent data from the Midwest Longitudinal Study of Asian American Families (MLSAAF) project, path analyses revealed that family enmeshment and youth-reported intergenerational conflict were associated with youth depressive symptoms, with negative emotionality serving as a mediator. The findings suggest that interventions aimed at reducing negative emotionality and improving parent-youth relationship quality and family boundaries could be helpful in reducing youth depressive symptoms.

For the “Briefly Gorgeous” Moment: Imagism and Queer Aesthetics in Ocean Vuong’s On Earth We’re Briefly Gorgeous

ABSTRACT Ocean Vuong’s epistolary novel On Earth We’re Briefly Gorgeous is distinguished by its highly sensory, descriptive, and fragmented linguistic style, coupled with an anachronic, multi-line narrative strategy. These stylistic elements exemplify salient modernist aesthetics, particularly resonating with the tenets of the Imagist movement. Through the presentation of fleeting images and juxtaposed scenes across temporal and spatial boundaries, Vuong’s fiction delineates the narrator’s transient, synesthetic recollections which merge into a dynamic flow of conscious duration, constituting a notable queer racial formalist work. Moreover, Vuong’s richly sensory and affective portrayal facilitates an embodied engagement with external spaces, unraveling the complex layers of the protagonist’s Asian American queer identity. By integrating a corporeal perspective into the aesthetic process of receiving and composing, Vuong reconfigures the traditionally passive bottom role toward a more dynamic and inclusive queer performance, thus challenging the entrenched heteronormative constructions that comply with Western imperialist and masculinist discourses. Beyond empowering the “abject” bottom, Vuong’s novel also posits a shared vulnerability inherent in queer bodies, envisioning a side path for the minoritarian groups.

Dr. Ling-Chi Wang reflections on Lau v. Nichols (1974): Bilingual education, language rights, and political activism

ABSTRACT Born in Xiamen, China in 1938, Dr. Ling-Chi Wang was the founder of Chinese for Affirmative Action, an organization focused on affirmative action in employment, representation of the Chinese in politics, voting, and language rights. He is also a Professor Emeritus of Asian American Studies at the University of California Berkeley. Ling-Chi established the Asian American Studies program at Berkeley, teaching its first course in 1969. In this paper, Ling-Chi shares his perspectives on the long history of Chinese discrimination dating back to the Chinese Exclusion Act (1882) and his years as a political activist during the 1960s to the present in San Francisco’s Chinatown. His role in community organizing was pivotal in the events leading up to this pivotal U.S. Supreme Court case. Ling Chi’s reflections on activism and linguistic justice documents his imprint on the this language rights case that has shaped US educational language policies for the last fifty years.

Interconnectedness of mindfulness facets and their impact on mental health outcomes in Asian American and European American college students: A network approach.

Despite extensive research supporting the effectiveness of mindfulness-based interventions, the understanding of the dynamic connections between various mindfulness facets, particularly across diverse cultures, remained limited. This study aimed to investigate the networks among mindfulness aspects across different cultural backgrounds and their individual associations with mental health and well-being. Using the data collected from 710 undergraduate students in Hawaii (445 Asian Americans, 265 European Americans), we constructed sparse networks for each group to investigate their centrality index. To compare the overall structures of these networks, we utilized permutation-based tests. In addition, we used relative weight analysis to evaluate the distinct contributions of each mindfulness facet to positive and negative mental health outcomes. The results indicated similar trends in both racial groups, emphasizing the importance of specific mindfulness aspects like describing and acting with awareness within the mindfulness construct. However, notable variations were observed, particularly in how observing and nonjudging facets related among Asian Americans. In addition, acting with awareness and nonjudging showed substantial inverse associations with negative mental health outcomes across groups, whereas the observing aspect displayed positive connections with anxiety and stress among Asian Americans. The findings suggest which aspects are fundamental to mindfulness, aiding in a nuanced understanding of the construct. They also emphasize the importance of acknowledging cultural diversity in both mindfulness research and its clinical applications. Practical implications and directions for future research were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The role of ethnic enclaves and neighborhood socioeconomic status in invasive breast cancer incidence rates among Asian American, Native Hawaiian, and Pacific Islander females in California.

Few studies have examined whether the incidence rates of invasive breast cancer among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations differ by the neighborhood social environment. Thus, we examined associations of ethnic enclave and neighborhood socioeconomic status (nSES) with breast cancer incidence rates among AANHPI females in California. A total of 14,738 AANHPI females diagnosed with invasive breast cancer in 2008-2012 were identified from the California Cancer Registry. AANHPI ethnic enclaves (culturally distinct neighborhoods) and nSES were assessed at the census tract level using 2007-2011 American Community Survey data. Breast cancer age-adjusted incidence rates and incidence rate ratios (IRRs) were estimated for AANHPI ethnic enclave, nSES, and their joint effects. Subgroup analyses were conducted by stage of disease. The incidence rate of breast cancer among AANHPI females living in lowest ethnic enclave neighborhoods (quintile (Q)1) were 1.21 times (95% Confidence Interval (CI) 1.11, 1.32) that of AANHPI females living highest ethnic enclave neighborhoods (Q5). In addition, AANHPI females living in highest vs. lowest SES neighborhoods had higher incidence rates of breast cancer (Q5 vs. Q1 IRR = 1.30, 95% CI 1.22 to 1.40). The incidence rate of breast cancer among AANHPI females living in low ethnic enclave + high SES neighborhoods was 1.32 times (95% CI 1.25, 1.39) that of AANHPI females living in high ethnic enclave + low SES neighborhoods. Similar patterns of associations were observed for localized and advanced stage disease. For AANHPI females in California, incidence rates of breast cancer differed by nSES, ethnic enclave, when considered independently and jointly. Future studies should examine whether the impact of these neighborhood-level factors on breast cancer incidence rates differ across specific AANHPI ethnic groups and investigate the pathways through which they contribute to breast cancer incidence.

Maternal, Perinatal, and Infant Health of Disaggregated Asian American Subgroups: A Scoping Review

Maternal, Perinatal, and Infant Health of Disaggregated Asian American Subgroups: A Scoping Review

Love isn’t colorblind: Internalized racism, resistance and empowerment against racism, and Asian American men’s racialized dating preferences.

Love isn’t colorblind: Internalized racism, resistance and empowerment against racism, and Asian American men’s racialized dating preferences.

Racism, Attachment Styles, and Mental Health among Asian American Adolescents

Theory suggests that a secure base can moderate the effects of racism on mental health outcomes among people of Color (Mikulincer &amp; Shaver, 2022). Thus, the current study tested this hypothesis with a sample of 301 Asian American adolescents who completed a 25-minute online survey. Two hierarchical multiple regression models examined whether secure, anxious, and avoidant attachment with mothers and fathers moderated the link between racism and mental health. We found that when Asian American adolescents reported frequent experiences of racism, secure attachment with fathers was not enough to mitigate the effects of racism. Specifically, simple slopes indicated that at high and moderate levels of secure attachment with fathers, adolescents reported slightly better mental health with few racism experiences but indicated a slight decrease in mental health with frequent racism experiences. Findings highlight the importance of dismantling racial discrimination to support Asian American adolescents’ mental health.

‘But you’re Asian! How can you not do well in higher education?’

ABSTRACT Asian American college students have increased significantly in the United States, yet little is known about Asian male immigrant doctoral students’ experiences on college campuses. The author links tenets of AsianCrit with counterstories of his encounters with and resistance against whiteness in research preparation and work settings as a Chinese immigrant doctoral student at a predominantly white institution in the Pacific Northwest. Implications include how scholars can historicise research on Asian immigrant doctoral students, combine critical theories to interpret the racialisation and strategic (anti)essentialism of Asian immigrant doctoral students, and use Asian immigrant doctoral students’ counterstories to advocate for just systemic changes. The article concludes by discussing the importance of caring for the well-being of Asian immigrant doctoral students, and empowering them to share their racialised counterstories for justice and healing.

The Science of Teaching Reading is Incomplete without the Science of Writing: A Randomized Control Trial of Integrated Teaching of Reading and Writing

ABSTRACT Purpose We conducted a randomized control trial of an instructional program, SRSD Plus, which integrates reading for writing to inform, writing, oral language, spelling and handwriting for students in Grades 1 and 2. Method A total of 10 teachers and their 248 students in Grade 1 (n = 121) and Grade 2 (n = 127) in the southwestern part of the US participated. The teachers included 6 White individuals, 2 Asian Americans, 1 Hispanic individual, and 1 person from another racial or ethnic background. Among the students, 46% were Asian American, 33% were Hispanic, 14% were White, and 5% were identified as multiracial. Teachers were randomly assigned to the SRSD Plus or business-as-usual (BAU) condition; students were assessed at pretest and posttest on writing, oral language, transcription, and reading skills. Results Multilevel model results showed that students in the SRSD Plus condition outperformed those in the BAU condition in spelling, vocabulary, sentence proficiency, planning from source text, discourse knowledge, and writing productivity and writing quality in source-based informational genre (.14 ≤ Effect Size [ES] ≤ .72), but not in word reading or handwriting fluency. Furthermore, although not the target genre, there was a positive transfer effect on writing outcomes in the opinion genre (.22 ≤ ES ≤ .34). Conclusion Integrated reading and writing instruction in SRSD Plus can improve primary grade students’ writing, discourse knowledge, planning, oral language, and spelling skills. Theoretical and practical implications and future directions are discussed in the context of the Science of Teaching Reading.

“Ew, what’s that smell?” Asian Americans’ experiences of culinary racism.

“Ew, what’s that smell?” Asian Americans’ experiences of culinary racism.

Shattering monolithic myths: gender gaps in STEM major selection across Asian American ethnic subgroups

Investigations into fostering gender parity in STEM have proliferated, yet the specific situation of Asian American women has been largely overlooked. Harnessing data from the High School Longitudinal Study of 2009 (HSLS:09), the analysis scrutinizes gender disparities in STEM major selections within distinct Asian American ethnic cohorts, accentuating the pivotal role of math self-efficacy. Pronounced gender disparities were discerned among Vietnamese/Thai and Filipino constituencies, as contrasting with their Chinese, Indian/Sri Lankan, and Japanese/Korean counterparts. For Vietnamese/Thai females, the disparity is partly attributable to diminished math self-efficacy, a dynamic not seen in Filipino disparities. These findings necessitate targeted interventions that foster female interest in STEM, while underscoring the imperative of ethnic specificity. It is paramount that strategies bolster the math confidence of Vietnamese/Thai females, thereby mitigating the deleterious effects of stereotypical expectations and ensuring equitable participation and outcomes.

Omissions and Marginalization: Asian American Representation in Art History and Education

Asian Americans have been historically marginalized and underrepresented in U.S. history and education due to stereotypes and the essentialization of diverse ethnicities and cultures. This article explores the exclusion of Asian American arts and artists through the lens of Asian Critical theory. The near invisibility and misunderstanding of Asian American arts have impacted art education, which remains centered on Whiteness and Euro-Western perspectives. To disrupt the status quo, more artists and art educators are striving to enhance the representation of Asian American arts and address the racism against Asian and Asian American communities. The article suggests two pedagogical approaches: (a) designing an inclusive curriculum incorporating diverse representations of Asian American artists; and (b) creating spaces for students to engage in counterstorytelling. It concludes by urging art educators to incorporate Asian American arts and experiences and foster critical discussions on racism against Asian Americans in the U.S. in their teaching and research.

Community Archives as Agency: Intersectionality as a Framework to Document Chinese American Experiences in the United States

The U.S. has a history of anti-immigrant and anti-Asian. Asian Americans strive for agency in defining their identities. Intertwined with their history of exclusion is the absence and misrepresentation of Asian Americans in archives. In this dissertation, I first explore Chinese Americans’ understanding of their identity and its reflection of social inequality. Then, I investigate what they want to preserve to document their history to counter injustice. Lastly, I examine how Chinese Americans want to use community archives to enhance agency and fight against social injustice. I use interviews, workshops, and ethnographic methods to collect conversations with 17 participants who self-identify as Chinese descendants in the U.S. My dissertation finds that participants’ racial and ethnic identities shape their experiences of discrimination, pressure to assimilate to White society, a lack of belonging, and difficulty fitting into the Asian American Pacific Islander group. Furthermore, gender identity influences their experiences. For example, Chinese American women often face social expectations to prioritize family over themselves. Alongside unjust experiences, community members share lived experiences of resilience, joy, and achievements. My dissertation proposes intersectionality as a framework to understand the representational value of community archives. The intersectionality framework asserts, “it is not enough to simply ‘add race and stir’” (Smooth, 2013). My dissertation finds that participants challenge a thing-oriented approach that prioritizes preservation alone. Instead, they prefer an engagement-oriented approach that uses archives to transform counter-stories into agency, specifically into what Yosso (2005) calls cultural wealth, such as aspirational and social capital.

The Longitudinal Impact of Family, Religious, and School Support on the Mental Health of Filipino and Korean American Youth Across Adolescence.

Asian Americans, currently the most rapidly expanding racial group in the USA, are experiencing persistent mental health inequities. These inequities are particularly pronounced during adolescence, highlighting the critical need for dedicated focus on this demographic. Social support is a key shield against mental distress among these adolescents, yet little research has examined the collective impact of multiple sources of support over time, across developmental stages, and for different ethnic subgroups. Drawing on the integrated conceptual framework, this longitudinal study is the first to our knowledge to examine how support from families, religious organizations, and schools together predicts mental health over time across adolescents' developmental stages. We further examined how these relationships may be moderated by age groups, distinguishing between the early adolescence cohort and the middle adolescence cohort. Data were from the Midwest Longitudinal Study of Asian American Families (MLSAAF) project that survey-interviewed 378 Filipino American and 408 Korean American adolescents (Mage = 15years). Findings reveal that family support consistently buffers against mental distress throughout adolescence for both groups. Religious support distinctly aids Filipino American early adolescents, while school support notably benefits early adolescents regardless of ethnicity. These findings emphasize the universal protective effects of social support, while also highlighting the nuanced ways that developmental stage and ethnicity may influence how different sources of support impact mental health. This underscores the need for developmentally and culturally sensitive mental health strategies for Asian American adolescents.

Training Community Health Workers to Respond to Public Health Demands

ABSTRACT Background Community health workers (CHWs) connect individuals to community resources and build individual competence in an effort to improve overall community/public health. There is a need for more research on how community health nurse (CHN)-led training programs are needed to help train and support CHWs. Purpose The purpose was to describe the development and evaluation of a series of CHN-led CHW trainings on CHW role, boundaries, and motivational interviewing; diabetes; mental health and long COVID; sexually transmitted infections; and lead poisoning prevention and treatment. Design This study utilized a one-group pretest-posttest design in which quantitative and qualitative data were collected. Methods The sample consisted of CHWs representing White/Caucasian, Black/African American, Hispanic/Latinx, and Asian American populations who for each topic, completed a pretest one week prior to the training, the training, and a posttest one week after the training. The quantitative and qualitative data collected during winter and spring/summer 2023 underwent statistical and thematic analysis, respectively. Findings The results suggest that the CHW trainings were effective overall at increasing participants’ knowledge and confidence in their knowledge levels, as well as comfort with educating community members on various public health topics. Information learned and found most helpful, and application and utilization plans for this knowledge in their work were revealed. Conclusions CHWs are important for disseminating health communication and education among members of their communities, and play a key role in reducing health disparities among at-risk populations. Clinical Evidence CHN-led educational intervention is a strategy to improve CHWs’ knowledge, confidence, and comfort.

Theatre of the Oppressed to Teach Medical Students About Power, Lived Experience, and Health Equity.

A difficult challenge in health equity training is conducting honest and safe discussions about differences in lived experience based on social identity, and how racism and other systems of oppression impact health care. To evaluate a Theatre of the Oppressed workshop for medical students that examines systems of oppression as related to lived health care experiences. Mixed-methods cross-sectional survey and interviews. Forty randomly assigned early first-year medical students. A 90-min virtual workshop with three clinical scenes created by students where a character is being discriminated against or oppressed. During performance, students can stop scene, replace oppressed character, and role play how they would address harm, marginalization, and power imbalance. Participants discuss what they have witnessed and experienced. Likert-scale questions assessing workshop's impact. Open-ended survey questions and interviews about workshop. Thirty-one (78%) of 40 participants completed the survey. Fifty-three percent were female. Thirty-seven percent were White, 33% Asian American, 15% Black, 11% Latinx, and 4% multiracial. Ninety percent thought this training could help them take better care of patients with lived experiences different from their own. Most agreed or strongly agreed the workshop helped them develop listening (23, 77%) and observation (26, 84%) skills. Twelve (39%) students felt stressed, while 29 (94%) felt safe. Twenty-five (81%) students agreed or strongly agreed there were meaningful discussions about systemic inequities. Students reported the workshop helped them step into others' shoes, understand intersectional experiences of multiple identities, and discuss navigating and addressing bias, discrimination, social drivers of health, hierarchy, power structures, and systems of oppression. Some thought it was difficult to have open discussions because of fear of being poorly perceived by peers. Theatre of the Oppressed enabled medical students to engage in meaningful discussions about racism and other systems of oppression.